Effect of polishing versus glazing of CAD-CAM ceramics on wear and surface roughness of opposing composite resin.

Background: This study aimed to assess the effect of polishing versus glazing of computer-aided design-computer-aided manufacturing (CAD-CAM) ceramics on depth of wear and surface roughness of opposing composite resin. Materials and Methods: This in vitro study was conducted on 40 Z250 composite and 40 CAD-CAM ceramic specimens including Celtra Duo, Vita Mark II, e.max CAD, and Vita Suprinity ceramics. All ceramic specimens were roughened by a fine-grit bur after primary glazing to simulate an adjusted surface in the clinical setting. They were then randomly assigned to two subgroups and underwent reglazing or polishing. All composite and ceramic specimens underwent profilometry after surface treatment and prior to the wear test, and the results were recorded quantitatively. Composite specimens were then subjected to 120,000 wear cycles against ceramic specimens in a chewing simulator, and the depth of wear was measured by a scanner. Data were statistically analyzed by repeated measures two-way analysis of variance (ANOVA) and one-way ANOVA (α = 0.05). Results: Comparison of the surface roughness of composite specimens before and after the wear test revealed significant differences in both glazed Suprinity (P = 0.048) and Vita Mark II (P = 0.026) ceramics groups. The change in surface roughness after the wear test (compared with baseline) was significant in glazed (P = 0.000) and polished (P = 0.013) Vita Mark II and polished Suprinity (P = 0.037) ceramics, but this change was not significant in other ceramics (P > 0.05). The depth of wear after the wear test was not significantly different among the ceramic and composite subgroups (P > 0.05). Conclusion: Assessment of depth of wear and surface roughness of composite specimens showed that the polishing kits of CAD-CAM ceramics can serve as a suitable alternative to reglazing.

Comparison of GAP, R-GAP, and new trauma score (NTS) systems in predicting mortality of traffic accidents that injure hospitals at Mashhad University of medical sciences.

Background: There are several trauma scoring systems with varying levels of accuracy and reliability that have been developed to predict and classify mortality in trauma patients in the hospital admission. Considering the importance of the country's emergency organization and the World Health Organization in the category of traffic accidents, we used this information in the study. The objective of this study is to evaluate and compare the predictive power of three scoring systems (R-GAP, GAP, and NTS) on traffic accident injuries. Methods: In an analytical cross-sectional study, all the data related to the mission of traffic accidents at the pre-hospital emergency management of Mashhad University of Medical Sciences in 2022 were extracted from the automation system, and the outcome of the patients in the hospital was recorded from the integrated hospital system. Then, GAP, R-GAP, and New Trauma Scores (NTS) were calculated, and their results were compared using ROC curve and logistic regression. Results: In this study, 47,971 injuries from traffic accidents were evaluated. Their average age was 30.16 ± 10.93 years. R-GAP showed negligible difference than GAP and NTS scores (the area under the curve equals 0.904, 0.935, and 0.884, respectively), and the average scores of R-GAP, GAP, and NTS are equal to 22.45/45 ± 1/9, 22.25 ± 1.5, and 22.49 ± 1.3, respectively. Injury severity based on R-GAP, GAP, and NTS scores was mild in most patients. The effect of these models on the patient outcome based on OR values, R-GAP, GAP, and NTS models showed high values. All analysis was performed in SPSS 26. Conclusion: According to the study results, it seems that R-GAP, GAP, and NTS, have the highest power to predict death in traffic accident injuries. It is recommended to include these points in the electronic file of the pre-hospital emergency for the injured. Also, the severity and outcome of the patient can be predicted by these scores, which play an important role in the triage of the injured and determining the appropriate treatment center.

HIV-1 Drug Resistance Profiles for the HIV Protease and Reverse Transcriptase Gene in Patients Receiving Combination Therapy in Tehran, Iran.

BACKGROUND: Determination of the drug-resistant mutations has a crucial role in the management of HIV-1 infected patients. OBJECTIVE: The aim of the current study was to evaluate drug resistance profile of Reverse transcriptase and Proteasegenes, and to find the correlation between drug resistance mutations and ART regimen to intensifyphysicians'options for the most effective therapy which could also influence the establishment of health-related policies at the national level in Iran. METHOD: HIV-1 RNA of 34 samples was extracted from plasma and RT Nested- PCR was performed and the final products were sequenced. Stanford HIV drug resistance sequence database was used for interpretation of the data. RESULTS: In 14 patients out of 15, the following mutations were observed; Nucleoside RT Inhibitor (NRTI)-Resistance Mutations with the prevalence of 11 patients having this mutation at codon 184 (73%) and Non-Nucleoside RT Inhibitor (NNRTI)-Resistance Mutations with the prevalence of 8 patients having NNRTI mutations at codon 103(53%).In 17 patients, major Protease Inhibitor (PI) Resistance Mutations were found out in 2 (12%) of them while the minor PI was found in7 (41%) patients. CONCLUSION: An antiretroviral treatment consisting of nucleoside reverse transcriptase inhibitor, non-nucleoside reverse transcriptase inhibitor and protease inhibitor, impairs the emergence of a resistant strain and descends its prevalence among the community. Having a high rate mutation in participants of this study raises concerns about treatment failure in HIV infected people in Iran. Observing high mutations rates in participants of this study raises concerns about treatment failure in HIV infected people in Iran.

Neurological Manifestations of Renal Diseases in Children in Qazvin/ Iran.

OBJECTIVE: Renal diseases are one of the most common causes of referrals and admissions of children, hence it is important to know their neurological presentations. This study aimed to determine neurological presentations of renal diseases in children. MATERIAL & METHODS: A total of 634 children with renal diseases, admitted to Qazvin Pediatric Hospital, Qazvin, central Iran from 2011 to 2013 were studied. Neurological presentations of patients were established and the results were analyzed using statistical tests. RESULTS: Neurological presentations were found in 18 (2.8%) out of 634 patients, of whom 15 had febrile seizures, two thromboembolism, and one encephalopathy. Among patients with urinary tract infection (UTI), 2.6% had febrile seizures, 11.1% of those with glomerulonephritis had encephalopathy, and 3.7% of those with nephrotic syndrome had cerebral thromboembolism. CONCLUSION: Results showed neurological presentations in 2.8% of children with renal diseases, and febrile seizure as the most common presentation.

The correlation between end-tidal carbon dioxide and arterial blood gas parameters in patients evaluated for metabolic acid-base disorders.

BACKGROUND: The analysis of arterial blood gas (ABG) is an invasive procedure that is used frequently in the emergency department (ED) to evaluate the acid-base status of critically-ill patients. However, capnometry is an alternative procedure that has been used in recent years to determine the metabolic status of patients' blood. Considering the correlation between end-tidal carbon dioxide (ETCO2) and arterial partial pressure of carbon dioxide (PaCO2) identified in the previous studies and the strong correlation between PaCO2 and bicarbonate (HCO3(-) ), we assumed that ETCO2 might be a useful parameter in predicting the presence of metabolic acidosis. The aim of this study was to determine the correlation between ETCO2 and the parameters of ABG in adult patients who were likely present metabolic acid-base disturbances in the Emergency Department of Imam Reza Hospital, the largest academic hospital in Mashhad in northeast Iran. METHODS: This was a cross-sectional study conducted during six months on 62 adult patients who presented with suspected metabolic acid-base disorders to the ED. The exclusion criteria were patients with chronic obstructive pulmonary diseases, loss of consciousness, intubated patients, and those who were unable to tolerate capnography. The patients' demographic information and vital signs were recorded. Also, ABG and ETCO2 results were recorded. The Pearson product moment correlation analysis and linear regression were used to determine the correlation between ETCO2 and ABG parameters. RESULTS: Sixty-four patients were enrolled, consisting of 37 men and 27 women with a mean age of 55.4 ± 22.7 years. The most common complaints presented were nausea and vomiting (n = 24). The average value for ETCO2 was 26.2 ± 6.1. There were significant linear correlations between ETCO2 level, pH (r = 0.368), HCO3(-) (r = 0.869), PaCO2 (r = 0.795), and Base Excess (B.E.) (r = 0.346). HCO3 and PaCO2 were the significant predictor values for ETCO2 (linear regression analysis). CONCLUSION: ETCO2 can be an appropriate indicator to estimate HCO3(-) and PaCO2 in critical emergency situations, but it cannot be used as an indicator to estimate all ABG variables.